Rural Cancer Control
Evidence has shown that rural communities in the United States face disadvantages compared with urban areas, including higher poverty rates, lower educational attainment, and lack of access to health services. Populations living in rural areas have higher average death rates for all cancer sites combined, compared to populations in urban counties. Additionally, rural counties have higher incidence and death rates for cancers associated with smoking (e.g., lung and laryngeal cancers) and higher rates of incidence of cancers that can be prevented by screening (i.e., colorectal and cervical cancers).
Some of the higher incidence and mortality rates for cancer can be attributed to barriers in accessing health services in rural areas. Research has also shown that some of these cancer disparities relate to financial barriers (e.g., no insurance or insufficient insurance coverage), transportation issues, and lack of preventive and screening services. There are also rural-urban differences in health behaviors that are associated with cancer, including higher rates of tobacco use, alcohol consumption, and obesity, and less physical activity, less-frequent adoption of sun safety measures, and lower HPV vaccination rates in rural compared to urban areas.
Currently, DCCPS has few funded projects focused specifically on rural populations. This long-standing public health challenge calls for sustained support for research along the entire cancer control continuum. We also need to better understand the various definitions of the term “rural” and their uses in health research – and specifically for cancer control. Focused research initiatives would provide the groundwork to develop and implement cancer control programs that are sustainable in these communities across the United States. In recognition of this need and to inform NCI’s efforts to better address cancer disparities in rural communities, DCCPS staff are working closely with our agency partners and a wide variety of experts to analyze the current evidence and scale up our research efforts in rural cancer control.
- Intervention Research to Improve Native American Health (IRINAH)
- Integration of Individual Residential Histories into Cancer Research (R21)
- Integration of Individual Residential Histories into Cancer Research (R01)
- Academic Research Enhancement Award (Parent R15)
- Collaborative Minority Health and Health Disparities Research with Tribal Epidemiology Centers (R01 Clinical Trial Not Allowed) (PAR-17-484)
- Collaborative Minority Health and Health Disparities Research with Tribal Epidemiology Centers (R21 Clinical Trial Not Allowed) (PAR-17-483)
- Improving the Reach and Quality of Cancer Care in Rural Populations (R01 Clinical Trial Required) (RFA-CA-18-026)
Selected Government-Supported Publications
- CEBP Focus: Rural Cancer Control. Cancer Epidemiology, Biomarkers & Prevention. November 2018. http://cebp.aacrjournals.org/rural18?utm_source=nov18&utm_medium=snippet&utm_campaign=rural18
- Saiontz N. NCI accelerates rural cancer control research. NIH Record. 2018 July 27; LXX(15):7. https://nihrecord.nih.gov/newsletters/2018/07_27_2018/story6.htm
- Houston KA, Mitchell KA, King J, White A, Ryan BM. Histologic lung cancer incidence rates and trends vary by race/ethnicity and residential county. J Thorac Oncol. 2018 Jan 19. https://www.ncbi.nlm.nih.gov/pubmed/29360512
- Blake KD, Moss JL, Gaysynsky A, Srinivasan S, Croyle RT. Making the case for investment in rural cancer control: an analysis of rural cancer incidence, mortality, and funding trends. Cancer Epidemiol Biomarkers Prev 2017 Jul;26(7):992-997. http://cebp.aacrjournals.org/content/early/2017/06/09/1055-9965.EPI-17-0092
- Croyle RT. Improving cancer control in rural communities: next steps. Cancer Currents Blog, National Cancer Institute, July 7, 2017. https://www.cancer.gov/news-events/cancer-currents-blog/2017/rural-cancer-disparities-next-steps
- Henley SJ, Anderson RN, Thomas CC, Massetti GM, Peaker B, Richardson LC. Invasive cancer incidence, 2004–2013, and deaths, 2006–2015, in nonmetropolitan and metropolitan counties — United States. MMWR Surveill Summ 2017;66(No. SS-14):1–13. https://www.cdc.gov/mmwr/volumes/66/ss/ss6614a1.htm?s_cid=ss6614a1_w
- Moss JL, Liu B, Feuer EJ. Urban/Rural differences in breast and cervical cancer incidence: the mediating roles of socioeconomic status and provider density. Womens Health Issues. 2017 Nov - Dec;27(6):683-691. https://www.ncbi.nlm.nih.gov/pubmed/29108988
- Moy E, Garcia MC, Bastian B, et al. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas — United States, 1999–2014. MMWR Surveill Summ 2017;66(No. SS-1):1–8. DOI: https://www.cdc.gov/mmwr/volumes/66/ss/ss6601a1.htm .
- 2016 update. Improving rural health: state policy options. National Conference of State Legislatures, 2016. http://www.ncsl.org/Portals/1/Documents/Health/RuralHealth_PolicyOptions2016.pdf
- Chartbook on rural health. Content last reviewed August 2015. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/ruralhealth/rural-chartbook.html
- May 30 – 31, 2018: Accelerating Rural Cancer Control Research, Natcher Conference Center, NIH Campus, Bethesda, MD
- Jan 18 – 19, 2018: Improving Health Research on Small Populations: A Workshop , National Academy of Sciences Building , Washington, DC
- August 30, 2017: Rural Cancer: Data, Disparities, and Determination
- May 4 – 5, 2017: Rural Cancer Control: Challenges and Opportunities
- November 10, 2016: National Meeting on Precision Medicine and Cancer in American Indian & Alaska Native Communities: A Dialogue on Cancer Research
- September 12 – 14, 2016: Conference on Geospatial Approaches to Cancer Control and Population
Details and updates will be posted as they become available